Breaking News
March 19, 2018 - Vitamin B12 supplementation could postpone disease progression in Parkinson’s patients
March 19, 2018 - Study shows that omega-6 fatty acids could protect against premature death
March 19, 2018 - TherapeuticsMD Announces FDA Acceptance of New Drug Application (NDA) and Prescription Drug User Fee Act (PDUFA) Date for TX-001HR
March 19, 2018 - Minorities More Sensitive To Pain? Pain Medicine News Report
March 19, 2018 - Low blood sugar poses unaddressed threat to people with type 2 diabetes
March 19, 2018 - ACEA goes live with exhaustive, searchable library of NovoCyte publications
March 19, 2018 - Consumption of low-calorie sweeteners could promote metabolic syndrome, increase diabetes risk
March 19, 2018 - Wearable medical patch shows promise for early detection of hypoglycemia in type 1 diabetes
March 19, 2018 - High-energy breakfast leads to better diabetes control and weight loss
March 19, 2018 - D.C. Week: Community Health Centers Get Azar’s Love
March 19, 2018 - Toothpaste alone does not prevent dental erosion or hypersensitivity
March 19, 2018 - Discovery aids understanding of amyotrophic lateral sclerosis
March 19, 2018 - Docs worry there’s ‘nowhere to send’ new and expectant moms with depression
March 19, 2018 - Obesity linked to increased DNA damage in breast epithelium of BRCA mutation carriers
March 19, 2018 - Heart rate increases with higher alcohol consumption
March 19, 2018 - Template produced for clinically validated DIY stethoscope
March 19, 2018 - Experts highlight nocturia as most common cause of poor night’s sleep
March 19, 2018 - Fit Middle-Aged Women May Fend Off Dementia Later
March 19, 2018 - Fake Insta Doc; Humana’s Weird Pay Bump Tax Trick; Few NPDB Searches
March 19, 2018 - Guidelines for fluoride intake—are they appropriate?
March 19, 2018 - Race and pre-pregnancy BMI may be key predictors of maternal weight gain
March 19, 2018 - Telediabetes program improves blood sugar control for veterans
March 19, 2018 - Research suggests breastfeeding as protective factor against obesity in high-birthweight infants
March 19, 2018 - Morning Break: House Nixes ‘Right-to-Try’ Bill; Purdue’s PR Makeover; Air in the Brain
March 19, 2018 - Heart researchers develop a new, promising imaging technique for cardiac arrhythmias
March 19, 2018 - Mice study shows how BPA exposure during pregnancy can lead to altered brain development
March 19, 2018 - Breastfeeding mothers who overeat may increase risk of health problems in offspring
March 19, 2018 - New mobile application can detect atrial fibrillation that causes strokes
March 19, 2018 - Study finds low rates of preconception counseling among women of childbearing age with diabetes
March 19, 2018 - Vitl Life Science Solutions announces launch of new Lu-mini at analytica 2018
March 19, 2018 - ObsEva SA Reports Positive Topline Results from IMPLANT2 Phase 3 Clinical Trial of Nolasiban in IVF
March 19, 2018 - D.C. Week: States Plead for Federal $$ in Opioid Fight
March 19, 2018 - Polycystic ovary syndrome – Genetics Home Reference
March 19, 2018 - Reducing co-payments improves patient, physician adherence to guideline-recommended treatment post-MI
March 19, 2018 - Normalizing estrogen levels can benefit female athletes with irregular menstrual periods
March 19, 2018 - Fitness trackers and virtual coaches motivate patients to exercise post cardiac rehab
March 19, 2018 - Atrial fibrillation patients could reduce risk of dementia by taking stroke prevention drugs
March 19, 2018 - Low sperm count more prevalent with other health problems finds study
March 19, 2018 - Male birth control pill taken once a day shows success
March 19, 2018 - AcelRx Announces Receipt of Type A FDA Meeting Minutes and Plans to Resubmit the DSUVIA New Drug Application in Q2 2018
March 19, 2018 - Eye Docs Adopt EHRs Despite Reservations
March 19, 2018 - CRISPR enhances cancer immunotherapy
March 19, 2018 - Study finds first evidence of delayed aging among Americans
March 19, 2018 - Aussies unaware of sun protection rules to prevent skin cancer
March 19, 2018 - Essential oils linked to abnormal breast development in boys
March 19, 2018 - ‘Tummy Tuck’ Relieved Postpartum Back Pain/Incontinence
March 19, 2018 - New biomarkers for neuroblastoma, a type of cancer in children
March 19, 2018 - Hookah Smoking Carries a Poisoning Risk
March 19, 2018 - Do Mood and Anxiety Affect MS Disability?
March 19, 2018 - Mean depth of ultrasonographic penetration greater in autism
March 19, 2018 - Platypus milk may help combat antibiotic resistance
March 19, 2018 - U.S. IDE study of THERMOCOOL SMARTTOUCH SF Catheter completes patient enrollment
March 18, 2018 - E-cigarette use exposes adolescents to potentially cancer-causing chemicals
March 18, 2018 - GOP Senator: Solve Opioid Crisis Through Community, Not Policy
March 18, 2018 - Why is ADHD more common in boys than girls?
March 18, 2018 - Measles alert after two passengers with the disease fly into US
March 18, 2018 - FDA looks to remove nicotine from cigarettes
March 18, 2018 - FDA moves to cut nicotine in cigarettes, helping smokers kick habit
March 18, 2018 - Athenex Announces Phase II Clinical Study Results for KX2-391 Ointment for the Treatment of Actinic Keratosis
March 18, 2018 - Surgery Tied to Better Outcomes in Kids with T2D
March 18, 2018 - Scientists use nanotechnology to detect molecular biomarker for osteoarthritis
March 18, 2018 - Research establishes use of chimeric cells as potential therapy for Duchenne muscular dystrophy
March 18, 2018 - Researcher working to develop improved endoscopic probe for colonoscopies
March 18, 2018 - Researchers develop way to sequence entire fetal genome by modifying prenatal testing method
March 18, 2018 - FDA Approves PDUFA Fee Waiver for Gimoti New Drug Application
March 18, 2018 - P2Y12 Tx Subsidy Yields Positive Response from Docs, Patients
March 18, 2018 - Are Proteins in Formula Linked to Type 1 Diabetes?
March 18, 2018 - Exercise does not seem to increase bone marrow edema in healthy people
March 18, 2018 - Researchers delineate architecture of nuclear pore complex in yeast cells
March 18, 2018 - ‘It’s Just Ghetto-izing People’: What We Heard This Week
March 18, 2018 - Alzheimer’s disease: Neuronal loss very limited
March 18, 2018 - Study reveals impact of intense, changing work schedules experienced by medical interns
March 18, 2018 - Jobs That Keep the Mind Sharp … Even Into Retirement
March 18, 2018 - Facial Scarring Improved with Botulinum Toxin
March 18, 2018 - Data detectives shift suspicions in Alzheimer’s to inside villain
March 18, 2018 - Shorter Preventive TB Tx Effective for HIV+ Patients
March 18, 2018 - New technique for identifying alcoholism puts treatment options at patients’ and providers’ fingertips
March 18, 2018 - Researchers uncover four microRNAs as potential biomarkers for atrial fibrillation
March 18, 2018 - IRX Therapeutics Announces Initiation of Phase 2 Clinical Trial of IRX-2 in Squamous Cervical or Vulvar Intraepithelial Neoplasia 3
March 18, 2018 - OncoBreak: Learning from Silence; ‘Rigged’ Drug System; NCCN Guidelines Questioned
Postoperative pain control following extensive pelvic exenteration

Postoperative pain control following extensive pelvic exenteration

image_pdfDownload PDFimage_print

In the March issue of Diseases of the Colon & Rectum, surgeons from Australia discuss postoperative pain control following one of the most extensive operations performed for pelvic cancer. In an era where many studies have shown that patients do better after surgery with use of lesser amounts of opioid pain medication, this can be particularly challenging in those patients who have taken a significant amount of pain medication before surgery. This is exactly what was shown in this study. In a group of 99 patients undergoing the very extensive procedure of pelvic exenteration, an operation in which all pelvic organs are removed usually for advanced rectal, gynecologic, or urologic cancers, one-third of patients were already taking opioid medications for pain control preoperatively. The investigators were able to show that it is more difficult to control pain during their hospital stay in these patients.

Citation: Lim JS, Koh CE, Liu H, Solomon MJ, Johnstone CSH. The price we pay for radical curative pelvic exenterations: prevalence and management of pain. Dis Colon Rectum 2018;61(3):314-319.

The authors proposed using different types of pain control, including regional nerve blocks in order to lessen the need for opioid medication in these patients, something that is being performed more and more frequently. Doctors Kopp and Lanier of the Mayo Clinic, in an outstanding accompanying editorial, put this article into perspective. They explain how such opioid-sparing techniques do not apply solely to patients undergoing this specific operation, but rather apply to many different types of surgery. With the current opioid epidemic, they emphasize the concept of drug stewardship and stress that the approach to pain management “must always respond to individual patient needs and cannot simply become formulaic.” It is especially difficult to take care of patients who are already used to taking large amounts of pain medication. Multidisciplinary care is needed when these patients undergo surgical procedures.


Diseases of the Colon and Rectum Journal

Tagged with:

About author

Related Articles